Sexual life, options for contraception and intention for conception in HIV-positive people on successful antiretroviral therapy in Thailand

Abstract

This article reports on the sexual life of HIV-positive heterosexual men and women in a stable relationship and on successful antiretroviral therapy in Thailand. We focused on one side on their sexual practices and options for contraception, and on the other on their intention for conception and factors influencing it, in the time of highly active antiretroviral therapy. In a cross-sectional study, 200 participants completed a questionnaire. Eleven female participants took part in focus group discussions (FGD), based on their intention for conception. We used descriptive statistics, logistic regression, and Chi-square exact test to present the results from the questionnaire, and a narrative approach for the FGD results. The median age of the participants was 37 years. Almost all were sexually active (88%) and rarely engaged in risky sexual behavior. The most common method of contraception for women was the male condom (95%), followed by female sterilization (40%). Almost all men reported consistent condom use. One-third of the main sexual partners were HIV-negative. The intention for conception was significantly less after being diagnosed with HIV (29% intended pregnancies after HIV diagnosis vs. 72% before HIV diagnosis). Nevertheless, 25% of the participants expressed a desire to have a child. We found a significant positive association between the intention for conception and less years of being married, the lower number of children and the higher levels of education. Therefore, we conclude that HIV-positive men and women are sexually active and in need of comprehensive reproductive health care services including counseling on safe ways to conceive and offering a diverse choice of contraceptive methods to those who do not wish to have children.

Using Andersen’s Behavioral Model of Health Care Utilization to Assess Contraceptive Use among Sexually Active Perinatally HIV-Infected Adolescents in Uganda

“…Therefore, continuous professional development in the area of sexual and reproductive health should be made available to health care providers caring for adolescents and young women [ 41 ]. In this study, majority of the adolescents who used family planning used short-term methods of family planning which we mainly explain as owing to misconception about the method among health care providers [ 43 – 45 ]. In Uganda, majority of women are offered all major modern contraceptive methods at public health facilities [ 6 ].…”

The Migration Intentions of Young Egyptians

“…Numerous studies have considered intention as an immediate driver of certain behaviors such as smoking [31][32][33], sexual activity, contraception use, abortion [34][35][36][37], illicit drug use [38][39][40], and childbearing [41][42][43].…”

The role of family planning in elimination of new pediatric HIV infection

“…Those who do not wish to become pregnant can be supported to access and use contraception. Though fertility desire may increase for some women after starting ART, recent data suggest that on average HIV-infected women tend to want fewer children than HIV-uninfected women [19, 20, 21*]. In one study, HIV status was the firmest predictor of not wanting future children [21].…”

“…Drivers for not desiring children include fear of adverse health effects on the mother, fear of transmission to the child or to a partner, degree of knowledge about PMTCT interventions and their efficacy, financial hardship, community or provider stigma, death of a child, current ill health, leaving child an orphan, and having `enough' children [21–25]. Alternatively, desire for children among HIV-infected individuals is associated with having no or few children, partner's desire for children, awareness of and access to ART, being married few years, and higher education [19, 23, 25, 26]. Two studies showed a significantly higher desire for children among HIV-infected men than women [25**, 27].…”

“…Prevalence of dual method use among people living with HIV is generally low, with reports ranging from 2.3% to 23% [20, 27, 29, 34, 35]. Only two studies have reported high rates of dual method use, but both are from Thailand where sterilization rates among women with HIV are higher than in the general population and condom use has been a contraceptive and HIV prevention staple for decades [19, 37]. …”